HIV-related news in brief from the Dec 2003-Jan 2004 edition of Positive Living.
Centrelink changes passed
Several legislative changes affecting Centrelink payments were passed by parliament in late November. Among the changes are new powers for Centrelink to use computer data matching to identify suspected fraud, and restrictions on overseas travel for people receiving Centrelink payments, including a new 13-week maximum period overseas during which pensions can be paid in most cases.
Drug giants ease patents for poor
Global drug giant Roche has pledged not to file new patents for HIV and malaria drugs in the world’s least developed countries, including the whole of sub-Saharan Africa. The company also says it will not take action against generic drug manufacturers who infringe its existing patents in those countries. Roche already supplies its HIV protease inhibitors saquinavir and nelfinavir at cost price in these countries. The company also manufactures the fusion inhibitor T-20.
GlaxoSmithKline and Boehringer Ingelheim have signed separate deals with South Africa’s Treatment Action Campaign that will see the companies grant up to four licences to African generic drug manufacturers to permit them to make HIV antiretroviralsA medication or other substance which is active against retroviruses such as HIV.. The generic manufacturers will be able to sell the drugs to private and public sector organisations, and export them to 46 other African countries. The deals cover the Glaxo drugs AZT and 3TC and Boehringer Ingelheim’s nevirapine.
Anger over acrobat sacking
The Canadian theatre group Cirque du Soleil has drawn widespread protests and is being investigated by the San Francisco Human Rights Commission after it sacked one of its acrobats for being HIV-positive. Matthew Cusick, 32, was dismissed earlier this year by the company, which claimed the risky nature of his job meant he was a danger to other performers. US gay rights group Lambda Legal Defense has launched a boycott of the group’s shows in San Francisco and Las Vegas. —Montréal Gazette
Free Trade deal nears
Australian and US negotiators are reportedly close to signing a free trade agreement, but are yet to agree on the effect of such a deal on the prices Australia pays for prescription drugs. The New York Times reports that the powerful US pharmaceutical lobby is continuing to press for a watering-down of the Pharmaceutical Benefits Scheme[Pharmaceutical Benefits Scheme] The federal government program which subsidises medication costs in Australia. Anti-HIV drugs are part of a special part of the PBS called Section 100 (S100) which is used for expensive, highly specialised drugs. (PBS) as part of the deal, however Australian chief negotiator Steven Deady promised the PBS will not be part of the agreement: “We are not negotiating the Australian health care system,” he said.
The Productivity Commission has issued a draft report of its inquiry into the Disability Discrimination Act, including a review of the exemption allowing insurers to deny insurance to people with HIV/AIDS in some circumstances. NAPWHA has been invited to make further submissions to the inquiry, and has asked HIV-positive people who have experienced discrimination when applying for life, mortgage, travel or general insurance to contact the NAPWHA office on 1800 259 666.
New heads for AFAOAustralian Federation of AIDS Organisations. AFAO is the peak non-government organisation representing Australia's community-based response to HIV/AIDS. AFAO's work includes education, policy, advocacy and international projects. , AIDS Trust
Sydney Lord Mayor Lucy Turnbull has been appointed chair of the AIDS Trust of Australia, replacing Mr Chris Puplick, and Dr Darren Russell has been elected President of the Australian Federation of AIDS Organisations (AFAO), replacing Bill Whittaker, who will continue as vice-president. Dr Russell is the immediate past president of the Victorian AIDS Council, Senior Lecturer in Sexual Health at the University of Melbourne and a GP.
The best first-line treatment is…
The combination of AZT, 3TC and efavirenz is the most effective antiviralA medication or substance which is active against one or more viruses. May include anti-HIV drugs, but these are more accurately termed antiretrovirals. combination in people who have never taken treatment before, according to a landmark study published in the December 11 edition of the New England Journal of Medicine . The ACTG 384 study compared several different three and four drug combinations in 980 patients. Those taking the AZT/3TC/EFV combination were least likely to fail treatment after more than two years.
Adherence to antiretroviral dosing schedules is more important than CD4 count in predicting the survival of people with HIV/AIDS, a Canadian study suggests. The mortality rate for patients who took less than 75 percent of their medication on time was at least twice as high as that for patients who were more adherent. “These data suggest that patient nonadherence, instead of when antiretroviral therapy is initiated — may be the strongest determinant of patient survival,” the researchers said. —Ann Intern Med 2003;139:810-816
LipoA metabolic disorder in which fat in the face, arms, legs and buttocks is lost and/or fatty deposits appear in the abdomen, breasts and neck. different in women
Women with HIV lipodystrophy are more likely to experience generalised body fat loss, rather than a loss of fat on the face, arms and legs combined with fat gain in the belly, according to a study published in the December 15 edition of JAIDS . Researchers from the University of California at San Francisco analysed body fat changes in 605 HIV-positive and 210 HIV-negative women over a period of 2?? years. —AIDSmap
HAARTHighly Active AntiRetroviral Therapy ??? aggressive treatment of HIV infection using several different drugs together. may cause oxidative stress
People taking HAART have elevated levels of a key marker of oxidative stress, a study published in the December 15 edition of ClinicalPertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. Infectious Diseases has found. Oxidative stress refers to the process by which free radicals produced by normal cell processes can damage cells and tissue, and is associated with the development of diseases such as diabetes[Diabetes mellitus] A disorder in which sugars in the diet cannot be metabolised into energy due to a lack of the enzyme insulin. Late-onset diabetes mellitus may be a long-term side effect of some anti-HIV drugs. and the aging process. Researchers in Tennessee measured the levels of F 2 IsoP, a marker of oxidative stress, in 120 HIV-positive people, and found that 28 of the participants had high levels of the marker, 89 percent of whom were taking HAART. —AIDSmap
HepAny inflammation of the liver. It is usually caused by viral infection, toxic agents or drugs but may be an autoimmune response. It is characterised by jaundice, abdominal pain, liver enlargement and sometimes fever. The different types of viral hepatitis include hepatitis A (formerly called infectious hepatitis), hep B (serum hepatitis), hep C (formerly called non-A, non-B hepatitis), and hepatitis D, E, F and G. C vaccine trials begin
The first human trials of a promising hepatitis C vaccine are expected to begin soon. The experimental(Of a drug) Not licensed for use in humans, or as a treatment for a particular condition. Experimental drugs are studied in clinical trials to determine their safety and efficacy, and are sometimes made available via Special Access Schemes prior to their approval. vaccine, developed by the University of St Louis in the US in partnership with the drug company Chiron, is the first to be tested in humans. Although hepatitis C only causes serious illness in a minority of cases, more than 200,000 Australians are infected, including a large number of people with HIV, in whom the disease can be more serious and aggressive.
Lipo? It’s in your head
A group of Dutch researchers have suggested that lipodystrophy might be caused by the effect of antiretroviral drugs on the brain. In a letter to the November 22 edition of The Lancet, the doctors outline a hypothesisA supposition or assumption advanced as a basis for reasoning or argument, or as a guide to experimental investigation. that HAART might affect the autonomic nervous system, which controls involuntary muscles such as the heart and the digestive system. Although the hypothesis is so far untested, the researchers say that if it proved correct, it could explain the different ways that lipodystrophy affects different parts of the body.